Rommens PM, et al. - Given the increasing acceptance of retrograde transpubic screw osteosynthesis due to its minimal invasive technique and adequate stability, researchers retrospectively reviewed the results of 158 retrograde transpubic screw osteosyntheses in 128 patients with pelvic ring lesions including a pubic ramus fracture. A high-energy injury was reported in 63 patients and a fragility fracture of the pelvis was reported in 65 patients. The insertion of 146 screws (92.4%) was done through a percutaneous procedure. No vascular, neurological or urological complications were observed. Radiographic evidence of healing was evident in 90.3% of fractures (n = 75) with a follow-up of ≥ 6 months. The quality of primary reduction, secondary displacement, or screw loosening did not correlate to nonunion rate. Outcomes suggest that for stabilizing the anterior pelvic ring, retrograde transpubic screw is a reliable minimal-invasive osteosynthesis, also in fragility fracture of the pelvis.